Protein-protein interaction network analysis of cirrhosis liver disease.

Aim: Evaluation of biological characteristics of 13 identified proteins of patients with cirrhotic liver disease is the main aim of this research. Background: In clinical usage, liver biopsy remains the gold standard for diagnosis of hepatic fibrosis. Evaluation and confirmation of liver fibrosis stages and severity of chronic diseases require a precise and noninvasive biomarkers. Since the early detection of cirrhosis is a clinical problem, achieving a sensitive, specific and predictive novel method based on biomarkers is an important task. Methods: Essential analysis, such as gene ontology (GO) enrichment and protein-protein interactions (PPI) was undergone EXPASy, STRING Database and DAVID Bioinformatics Resources query. Results: Based on GO analysis, most of proteins are located in the endoplasmic reticulum lumen, intracellular organelle lumen, membrane-enclosed lumen, and extracellular region. The relevant molecular functions are actin binding, metal ion binding, cation binding and ion binding. Cell adhesion, biological adhesion, cellular amino acid derivative, metabolic process and homeostatic process are the related processes. Protein-protein interaction network analysis introduced five proteins (fibroblast growth factor receptor 4, tropomyosin 4, tropomyosin 2 (beta), lectin, Lectin galactoside-binding soluble 3 binding protein and apolipoprotein A-I) as hub and bottleneck proteins. Conclusion: Our result indicates that regulation of lipid metabolism and cell survival are important biological processes involved in cirrhosis disease. More investigation of above mentioned proteins will provide a better understanding of cirrhosis disease.


Introduction
1 Cirrhosis is the advanced stage of liver fibrosis.
In fibrosis, damaged tissues are replaced by collagen layers and lead to deficiency of the liver Liver Parenchymal cells are damaged by inflammatory reactions that can induce collagen synthesize, as well as a broad range of inflammatory cytokines and chemokines secretion (4). In Cirrhosis, normal liver architecture is disrupted by both fibrotic bands and disorganized nodules. Currently, no medical treatment for rebounding of cirrhotic changes is available (5). Cirrhosis usually occurs as a complication of previous chronic liver disease, such as autoimmune hepatitis, non-alcoholic fatty liver disease, hepatitis B or C viral infections (6). Now, the diagnostic information for cirrhosis is based on combined results of clinical test and imaging (1,7). However, due to some limitations, these methods cannot be satisfactorily applied to a sensitive clinical diagnosis (8,9). The liver biopsy is a diagnostic gold standard for determining liver disease severity, but this method is an invasive approach. Efforts have been focused on finding sensitive and specific predictive markers for early and non-invasive diagnosis of hepatic diseases (10). For this purpose, recognition of cirrhotic molecular pathways and their relations can be helpful to understand pathophysiological liver disease, early stage diagnosis and treatment in time. In recent years, related genes with cirrhosis have been introduced, including: apolipoprotein C-III, calponin 1, microfibrillar-associated protein 4, complement complement 7, lectin, galactosidebinding, soluble, 3 binding protein , lectin, galactoside-binding soluble 4 (Galectin-4), prolyl 4-hydroxylase, alpha polypeptide I, apolipoprotein A-I, apolipoprotein A-IV, transgelin, tropomyosin 2 and tropomyosin 4 (5, [11][12][13][14][15]. Introducing a biomarker panel for some diseases is an important goal in diagnostic and therapeutic aspects of medicine (16). Bioinformatics is one of the novel tools in research of the modern world that analyze high throughput data in a short time (17). Enrichment analysis of interest proteins can be helpful in understanding the significant intricate parts of cells and the underlying mechanism of the disease pathology. Many investigations on disease-related genes have been performed using enrichment analysis methods. According to these investigations, there are common relations and associations between an experimentally protein/gene set of interest and a database of gene/protein sets. (18,19). In this study, the enrichment analysis of identified proteins based on the GO and PPI are investigated to introduce some related molecular biomarkers (as a panel) to cirrhosis.

Materials and Methods
Using Google Scholar and PubMed are selected as search engians for protein identification. These proteins are expressed differentially in cirrhosis patients relative to the controls.
Names of related proteins were searched in uniprot and codes were extracted. The codes used in DAVID Bioinformatics Resources for GO analysis. A pack of gene annotations (e.g. functions, processes) can help identify interesting features. However, the prominent features are required for aqurate interpretation.
Thus, a method is required for routine analysis of such datasets. Gene Ontology (GO) as a common vocabulary for annotation allows to identify semantically related genes and gene products (20). There are separate hierarchies for Molecular Functions (MF), Cellular Components (CC) and Biological Processes (BP) (21). In fact, the DAVID Gene Functional Classification Tool (http://david.abcc.ncifcrf.gov) provides a list of associated biological terms into organized classes of related genes using a novel algorithm (22). Functional annotation software DAVID online program can provide functional information as clusters of sets of biological terms with similar meaning (23)(24)(25). Protein-protein associations can provide a clear point by grouping and organizing all protein-coding genes in a genome that can be assembled into a large network (26). The STRING database is designed to assemble and evaluate protein-protein association information (27). STRING 9.1 was used for illustration of predicted interactions of identified proteins and neighbor genes (28, 29). The PPI network was visualized using the Cytoscape 3.2.1 software. MINT, Reactome-Fls, databases were used for this topology visualization.

Results
Selected reported cirrhosis proteins (the proteins with significant effect) and their Uniprot IDs are tabulated in table 1. The provided Gene ontology (GO) information, including biological processes (BP), cellular components (CC), and molecular function (MF) of proteins are identified and illustrated in table 2. The studied proteins based on GO annotation were divided into five clusters using of the DAVID program (see table 3).
The integrated protein-protein interaction network was obtained from MINT, Reactome-Fls, and STRING databases using Proteomics Standard Initiative Common QUery InterfaCe (PSICQUIC) source (figures 1-3). Based on centrality parameters of the network (Degree and Betweeness), fibroblast growth factor receptor 4 (FGFR4), tropomyosin 4 (TPM4), tropomyosin 2 (beta) (TPM2), Lectin galactoside-binding soluble 3 binding protein (LGALS3BP) and apolipoprotein A-I (APOA1) are identified as hubs and bottlenecks (and also as hub-bottleneck elements) of network (table 4). Evaluation of protein-protein interactions provides excellent information about its role in the systematic function of protein network. STRING resource is a suitable toll for showing these interactions (10). Using STRING, the possible interactions for hubbottleneck proteins are presented in figure 3.

Discussion
Hepatic cirrhosis is a life-threatening disease arising from different chronic liver disorders. Liver cancer might occur as an end stage of steatosis, inflammation, fibrosis, and cirrhosis disease (32). Only a liver biopsy provides a reliable evaluation in grading inflammation and staging fibrosis. Therefore, non-invasive serum biomarkers for hepatic fibrosis with high sensitivity and specificity are needed (12). The use of annotation methods (mapping genes /proteins by gene ontology [GO]) can be helpful in understanding and gaining a better view of biological features of the interest sets of proteins (33). Various factors such as oxidative stress, altered nuclear receptors, cytokines signaling, mitochondrial / peroxisomal abnormality, Regulation of protein amino acid phosphorylation, immune response , cholesterol , steroid and lipid, metabolic process , cell motion, G-protein coupled receptor protein signaling pathway, regulation of hormone levels, very-low-density lipoprotein remodeling,, cellular amino derivative metabolic process, cholesterol homeostasis, positive regulation of catalytic activity, regulation of system process, cell motility, chemical homeostasis, regulation of cytokine secretion , protein stabilization, negative regulation of cellular component organization, trans membrane transport, lipid homeostasis, sterol homeostasis, regulation of cellular localization, macromolecular complex assembly Uniprot ID: 06727 Molecular Function Transporter activity for lipid, sterol and cholesterol, lipid binding, ion binding, cation binding, amine binding, alcohol binding, metal ion binding Cellular Component extracellular region, extracellular space, endoplasmic reticulum lumen, membrane-enclosed lumen, protein-lipid complex, plasma lipoprotein particle, very-low-density lipoprotein particle, high-density lipoprotein particle, chylomicron, , extracellular region part, intracellular organelle lumen Biological Process Cellular response to oxidative stress, cellular amino derivative metabolic process, regulation of system process, metabolic process, immune response, cell adhesion, leukocyte adhesion, cell -cell adhesion, regulation of cholesterol absorption, regulation of lipid catabolic process, regulation of molecular function and assembly subunits, regulation off fatty acid biosynthetic process, chemical hemostasis, catabolic process, lipid hemostasis, sterol hemostasis Uniprot ID: P33622 Molecular Function Llipid binding Cellular Component extracellular region, extracellular space, protein-lipid complex, plasma lipoprotein particle, very-low-density lipoprotein particle, triglyceriderich lipoprotein particle, chylomicron Biological Process lipoprotein trygriceride mobilization, lipid transport, lipid localization, catabolic process of lipid , glycerol , acyl glycerol and triglyceride  (39,40). Dysregulations of the expression, or activity of specific PPAR isoforms are also accepted to represent critical mechanisms contributing to the development of a wide range of liver diseases (41). As it is listed in table 1, there are 13 proteins-related to cirrhosis disease. However, additional investigation will be needed to elevate this number. According to DAVID information (see table 2), apolipoprotein A-I and apolipoprotein C-II appropriate in the PPAR signaling pathway; therefore, their related proteins may play a critical role in liver diseases. Previous studies showed that elevation of apolipoprotein A-I concentration is related to the degree of liver injury (25) . FGFR4, ubiquitous protein that has a key role in extracellular matrix (ECM) turnover during fibrogenesis, may be associated with the risk of HCC coupled with liver cirrhosis (42,43) and cirrhosis (30). FGFR4 contributes in the MAPK signaling pathway (25). Further understanding of common pathways in related proteins with special disease is essential for application in clinical settings. Recent studies have indicated MAPK signaling pathways play key roles and act as therapeutic targets in liver injury (44). As findings indicate, these studied proteins belong to PPAR signaling, MAPK signaling, Endocytosis, regulation of actin cytoskeleton, arginine and proline metabolism, drug metabolism, cardiac muscle contraction and hypertrophic cardiomyopathy (HCM) pathway.  According to DAVID, Based on GO analysis, most of the proteins are located in the endoplasmic reticulum lumen, intracellular organelle lumen, membrane-enclosed lumen and extracellular region. Molecular function analysis showed that actin binding, metal ion binding, cation binding, ion binding are the involved function in this liver disease. The relevant biological processes are cell adhesion, biological adhesion, cellular amino acid derivative metabolic process, chemical homeostasis and homeostatic process. Adhesion molecules are glycoproteins in the surface of cells that are essential for the leukocytes localization at sites of inflammation (45). In polycystic liver disease, the overexpression of growth factor receptors and loss of adhesion were reported (46). Alterations in inflammation-related components and soluble adhesion molecules are prognostic significance in the cirrhosis disease. Systemic inflammation is one of the significant elements that are involved in cirrhosis physiopathology. Systemic inflammation plays a considerable role in the cirrhosis-associated immune dysfunction syndrome (47). Some of the studied proteins are involved in the inflammatory response, while others are involved in lipid transport activity. They can effect on lipid composition of cellular membranes. This process changes plasma lipid and lipoproteins level (48). As it is depicted in tables 2 and 3, cirrhosis disease is characterized by a b the vast alterations in molecular functions, cellular components and biological processes. PPI network for cirrhosis disease (see figure 1)    LGALS3BP is involved in defense response, cell adhesion and biological adhesion processes. Possible interactions with neighboring proteins for hub-bottleneck proteins (see figure 3) provided valuable information for evaluation of the biological importance of these proteins. According to STRING database information (figure 3), related proteins of 5 hubbottleneck have been predicted. Pathways of hub neighbors were obtained from the QUICK GO (a web-based tool that allows easy browsing of the Gene Ontology) (52) proteins involved in the same pathway except LGALS3BP (figure 3). Related proteins with TPM4 and FGFR4 involved in skeletal muscle contraction and MAPK cascade, respectively. For APOA1, related proteins belong to retinoid metabolic process and transportation. The results of related proteins in TPM2 are the same TPM4.
Neighbors of hub proteins participate in the same pathway and the same function. Controlling the expression of these five proteins has considerable effects on pathology of cirrhosis disease. This achievement requires more investigation, especially following patients in the process of disease development.
In the clinical usage, liver biopsy (invasive method) still remains the gold standard for diagnosis of hepatic fibrosis. Biomarker discovery and molecular investigation are powerful tools in diagnosis and treatment of this disease. Proteinprotein interaction network analysis can elevate understanding of molecular events. Here, five proteins relative to cirrhosis were introduced as hub-bottleneck protein. It can be concluded that regulation of gene expression, including FGFR4, TPM4, TPM2, LGALS3BP and APOA1 proteins can play a key role in the pathology of cirrhosis disease. These findings indicated that the studied proteins belong to PPAR signaling, MAPK signaling, Endocytosis, regulation of actin cytoskeleton, arginine and proline metabolism, drug metabolism, muscle contraction and hypertrophic cardiomyopathy (HCM) pathway.